Arterial hypertension

What is arterial hypertension? It is a disease characterized by blood pressure above 140 mm Hg. Art. In this case, the patient is visited with a feeling of headache, dizziness and nausea. Only specially selected therapy can eliminate all the symptoms.

Arterial hypertension can be an independent disease or can be accompanied by various pathologies that are their symptoms. Hypertension is one of the causes of coronary heart disease and severe kidney damage.

In hypertensive patients, the indicators often return to normal only after taking special medications, and blood pressure increases can be observed regularly and for no apparent reason. It is not possible to completely cure the disease, but it is possible to prevent serious consequences and learn to manage your blood pressure.

Do not self-medicate. At the first sign of illness, consult a doctor.

Reasons

To date, the exact causes of major arterial hypertension are unknown. There are the following risk factors:

• heredity;
• malnutrition;
• bad habits;
• disorders of fat metabolism;
• kidney disease;
• diabetes;
• stress;
• inactive lifestyle.

Classification of the disease

It is very difficult to determine the location of the concentration of pathological factors that cause an increase in blood pressure during the diagnostic examination. The pathogenesis also differs depending on the type of disease. There are the following classifications of arterial hypertension:

1. Pulmonary arterial hypertension is a rare but life-threatening type of hypertension. This disease is very difficult to diagnose with symptoms and even more difficult to treat. Pulmonary arterial hypertension is caused by increased pulmonary vascular resistance and, as a result, insufficient blood flow.
2. Malignant. Symptoms of such arterial hypertension are presented in the form of increased blood pressure up to 220/130. there is a radical change in the fundus and swelling of the disc of the optic nerve. If diagnosed in time, it is possible to treat this type of hypertension.
3. Renovascular arterial hypertension. The causes of this type of disease are the presence of pathologies in the kidneys, such as vasculitis, vascular atherosclerosis, malignant formations. The pathogenesis of the disease decreases to the formation of characteristic pressure, which can be represented by normal systolic and high diastolic blood pressure.
4. Labile arterial hypertension. This type of disease is characterized by periodic normalization of blood pressure. Patients suffering from this form of arterial hypertension are not called patients because the condition is not pathological. In some cases, blood pressure returns to normal over a period of time.

Symptomatic arterial hypertension and its types

Secondary arterial hypertension is a pathological process associated with diseases of the organs involved in the normalization of blood pressure. It has the following classification:

1. Hemodynamic - is associated with a violation of hemodynamic conditions due to organic pathology of large vessels. This form of symptomatic arterial hypertension occurs due to sclerosis of the walls of the aortic chamber, coarctation of the aorta, aortic valve insufficiency.
2. Neurogenic. This type of symptomatic arterial hypertension occurs due to diseases of the peripheral nervous system, brain injuries, atherosclerosis.
3. Endocrinopathy. This form of symptomatic arterial hypertension is observed in hormonally active tumors of the adrenal glands, pituitary gland, diffuse toxic goiter.
4. Nephrogenic arterial hypertension. This type of symptomatic arterial hypertension occurs for the following reasons: inflammation of the kidneys, their compression, nephrolithiasis. Nephrogenic arterial hypertension is accompanied by a sudden onset, rapid and often malignant course. Nephrogenic arterial hypertension is divided into two types: renovascular and parenchymal.
5. Medication. This form of symptomatic arterial hypertension is associated with the use of drugs that increase blood pressure.

Symptoms

Before the complications of arterial hypertension, it continues without certain manifestations. The only symptom of this disease is high blood pressure. The pathogenesis of hypertension is reduced to the appearance of headaches behind the head and forehead, dizziness and uncharacteristic noise in the ears.

Target organ damage

Such symptoms of arterial hypertension occur primarily due to the increased sensitivity of these organs to increased pressure. The first stage of circulatory disorders is characterized by the formation of headaches and dizziness. Later, the patient develops weakness, blinking of black dots in front of his eyes, difficulty speaking. Such symptoms bother a person in the late stages of the disease. In addition, complications such as cerebral infarction and bleeding may occur.

Heart problem

In this case, the pathogenesis of the disease is reduced to an increase in the left ventricle due to a compensatory reaction aimed at normalizing the tension of the wall. As a result, increased load, heart failure. When the heart is damaged, there are no most favorable prognosis, because such changes in its work are the causes of heart failure, sudden death and the development of ventricular arrhythmias. Typical symptoms are:

• pulmonary edema;
• difficulty breathing during physical activity;
• cardiac asthma.

In some cases, arterial hypertension in children and adults causes pain in the heart region of a certain nature. They can visit a person in a state of rest or emotional stress without physical activity. The main manifestation of the presented chest pain is the impossibility of their elimination with the help of nitroglycerin.

In some patients, the pathogenesis of this pathological process is reduced after the implementation of small loads or at rest until the onset of shortness of breath in the early stages of the disease. All this indicates the characteristic changes in the heart muscle and the development of heart failure. People with this disease have swelling of the lower extremities due to the retention of sodium and water ions in the body.

If the lesion has affected the kidneys, a urine test will show a protein and microhematuria and cylindruria. In very rare cases, the pathogenesis of the disease involves the occurrence of renal failure.

Eye injury

Not very often, this arterial hypertension in children and adults affects vision, resulting in decreased sensitivity to light and blindness. If there is a visual impairment against the background of high blood pressure, patients have black dots in front of the eyes, fog or covering. The reasons for such changes are disruption of blood circulation in the retina. Complications can manifest themselves as diplopia, visual impairment, or complete vision loss.

headache

This symptom is the most common in hypertension. Worries the patient at any time of the day or night. In nature, there may be an explosion and it focuses on the back of the head and then spreads to the entire head area. Increased headaches in arterial hypertension occur during coughing, tilting the head. This can be accompanied by swelling of the eyelids and face. In this case, during massage, in patients suffering from arterial hypertension, there is an improvement in blood flow in the arteries, which leads to a decrease in pain until it disappears completely.

In the background of the presented disease, there are cases when the headaches are the result of the head itself or the tense soft muscles of the tendons. The formation of such a pain syndrome occurs after psycho-emotional or physical overload. As a rule, such pain is compression or contraction in nature. A patient suffering from arterial hypertension has nausea and dizziness. When there is long-lasting pain, persistent pain is characteristic, patients become irritable, sensitive to sharp sounds, irritable.

Stages of the disease

It is necessary to use the classification to correctly determine the stage of this pathological process. It depends on the target organ damage. There are three stages of the disease.

Easy

This stage is characterized by a slight increase in blood pressure of 180/100 mm Hg. Art. the pressure level is unstable. In a patient suffering from arterial hypertension, blood pressure readings return to normal at rest. Due to the fixation of the disease, the pressure inevitably rises. Often people do not complain of any health problems. But for an easy stage, its symptoms are characteristic:

• headaches;
• noise in the ears;
• bad sleep;
• mental retardation;
• dizziness;
• nosebleeds.

As a rule, there are no manifestations of left ventricular hypertrophy, no abnormalities in the ECG, no pathological changes in renal function, the fundus is not changed.

Medium

This stage is characterized by higher and more stable blood pressure. It can reach 180-105 mm Hg. Art. Patients often experience headache, dizziness, pain in the heart area with angina pectoris.

This stage is characterized by typical hypertensive crises. The pathogenesis of the disease includes the following signs of damage to target organs:

• left hypertrophy;
• weakening of the first tone in the upper part of the heart;
• II tone emphasis in the aorta;
• ECG symptoms of subendocardial ischemia in some patients.

As for the central nervous system, there are various manifestations of vascular insufficiency, stroke, transient cerebral ischemia. For the fundus, in addition to reducing arterioles, there is constriction of blood vessels, their growth, bleeding, exudates occur. Blood flow to the kidneys and the rate of glomerular filtration for this stage is reduced. However, it is not possible to detect these manifestations in urine analysis.

heavy

This stage of the disease is often characterized by vascular accidents. They are caused by a significant and steady rise in blood pressure, as well as the progression of atherosclerosis and atherosclerosis of larger vessels. At this stage, blood pressure reaches 230-120 mm Hg. Art. there is no spontaneous normalization of blood pressure. In a severe stage, the disease affects the following organs:

• heart - angina pectoris, circulatory failure, myocardial infarction, arrhythmia are formed;
• brain - ischemic and hemorrhagic infarctions, encephalopathy is formed;
• fundus;
• kidneys - low blood flow and glomerular filtration.

Risk factors

The severity of the disease currently described depends directly on the risk factors. The risk is in the formation of cardiovascular complications against the background of high blood pressure. Taking into account the presented complications, the prognosis of the consequences of arterial hypertension is diagnosed. There are the following risk factors that worsen the course and prognosis of the disease:

• age - after 50 years in men, after 60 years in women;
• to smoke;
• high cholesterol;
• hereditary factor;
• obesity;
• hypodynamics;
• diabetes.

Presented risk factors can be eliminated (corrected) and cannot be corrected. The first type of risk factors is characterized by diabetes, high cholesterol, smoking, physical inactivity. Unadjusted risk factors include race, family history, and age.

Given the degree of arterial hypertension and the factors that cause the disease, a prognosis is observed with the occurrence of complications such as heart attack or stroke over the next 10 years.

In the absence of mild arterial hypertension and risk factors, the development of cardiovascular complications is minimized over the next 10 years. It is possible to eliminate this degree of pathological process with non-drug therapy and reconsideration of your lifestyle for a year. If the pressure is more than 140/90 mm Hg. Art. , then drug treatment is prescribed.

The average risk rate of 20% for 10 years is accompanied by the formation of complications against the background of arterial hypertension. Grade 2 arterial hypertension is treated in the same way as grade 1, but here the dynamics control is also regulated within six months. If there are poor results of blood pressure and its maintenance, drug treatment is carried out.

High risk factors are associated with complications within 30%. In this case, a patient suffering from arterial hypertension is given a complete diagnosis with non-drug treatment.

The patient with a very high risk is prescribed an emergency differential diagnosis of arterial hypertension and medication.

Diagnostic methods

Only after a thorough examination can you prescribe effective therapy and eliminate all manifestations of this disease. Diagnosis of arterial hypertension is based on the following types of examination:

• ECG, glucose analysis and whole blood count;
• Ultrasound of the kidneys, urea in the blood, determination of creatinine levels, general urinalysis - to rule out the renal nature of the disease;
• If pheochromocytoma is suspected, ultrasound of the adrenal glands is recommended;
• hormone analysis, thyroid ultrasound;
• MRI of the brain;
• Consultation with a neurologist and ophthalmologist.

Effective Therapy

Treatment of arterial hypertension should be carried out under the constant supervision of a physician. It is obliged to make an accurate diagnosis and conduct additional diagnostics, including inspections:

• fundus;
• kidney function;
• the work of the heart.

After that, the specialist can prescribe antihypertensive treatment and various complications. As a rule, patients diagnosed with arterial hypertension syndrome for the first time are hospitalized to select all necessary tests and treatment.

Non-drug treatment

This type of therapy is recommended for all patients, regardless of the severity of the disease. Such treatments for hypertension include:

1. Quit smoking. It is very important to change your lifestyle, such changes serve as an excellent prevention of diseases of the cardiovascular system.
2. Eliminate extra pounds. The most common cause of high blood pressure is overweight, so diet plays an important role in this. In addition, a balanced and proper diet has a beneficial effect on risk factors such as diabetes mellitus, myocardial hypertrophy.
3. Taking a small amount of salt. According to ongoing research, reducing salt intake by 4. 5 g / day helps reduce systolic blood pressure by 4-6 mm Hg. Art.
4. Insignificant consumption of strong drinks.
5. Specially prepared diet. Your diet should include vegetables, fruits, high magnesium, potassium, potassium, fish, seafood. In addition, the diet includes limited intake of animal fats.
6. Active lifestyle. Here it is very useful to walk briskly for 30 minutes 3-4 times a week. Exercising isometric loads can cause an increase in blood pressure.

Treatment

Drug therapy should be prescribed taking into account the following recommendations:

1. Treatment begins with small doses of medication.
2. In the absence of a therapeutic effect, the use of one drug should be replaced by another. The interval between degrees should be less than 4 weeks, unless a rapid reduction in blood pressure is required.
3. Use of long-acting drugs to achieve a 24-hour effect with a single dose.
4. Application of optimal combination of devices.
5. Therapy should be continuous. The drug is not allowed to use in courses.
6. Effective blood pressure control throughout the year helps to gradually reduce the dose and amount of medication.

Preventive measures

Prevention of hypertension includes the following recommendations:

1. If family members have the disease and you are over 30, then you should have your blood pressure measured regularly.
2. Quit smoking and alcohol.
3. A low-fat and low-salt diet should be followed.
4. Exercise outdoors.
5. Avoid various stressful situations.
6. Maintain a normal body weight.

A person with arterial hypertension can live a normal full life, but follow all the recommendations described. In this case, blood pressure control is one of the key components of successful treatment of the disease. Therefore, to prevent various serious complications, try not to start the disease and consult a doctor in time.